中国医药导刊
中國醫藥導刊
중국의약도간
CHINESE JOURNAL OF MEDICAL GUIDE
2014年
1期
44-45
,共2页
纤维胆管镜%腹腔镜%微创%胆囊结石
纖維膽管鏡%腹腔鏡%微創%膽囊結石
섬유담관경%복강경%미창%담낭결석
Fiber choledochoscope%Laparoscopic%Minimally invasive%Gallstones
目的：探讨小切口胆管纤维镜取石术与腹腔镜联合纤维胆管镜取石术对在保胆取石中的临床疗效与安全性。方法：124例普外科收治的结石性胆囊炎患者作为研究对象,其中实验组(n=68)接受小切口纤维胆管镜下取石法治疗,对照组(n=56)接受腹腔镜联合纤维胆管镜取石法治疗。结果：手术时间、手术出血量、术后镇痛率及肠道排气时间组间比较差异无统计学意义(P>0.05),两组组中转开腹率(2.9% vs 16.0%)、结石残留率(1.5% vs 14.3%)比较差异具有统计学意义(x2=6.549,、7.493,P<0.05),实验组高于对照组。此外两组患者总并发症发生率比较差异无统计学意义(P>0.05),但实验组急性胰腺炎、胆管感染发生率少于对照组(5.9%、4.4%vs16.1%、12.5%),胆漏发生率高于对照组(20.6%vs5.4%),差异均有统计学意义(X2=4.776、4.169、7.681,P<0.05)。结论：两种微创的手术方法具有其各自的优势,在治疗方案的选择上应根据患者的实际情况选择合适的方法,降低手术对于患者的创伤,尽可能提高手术的治疗效果。
目的：探討小切口膽管纖維鏡取石術與腹腔鏡聯閤纖維膽管鏡取石術對在保膽取石中的臨床療效與安全性。方法：124例普外科收治的結石性膽囊炎患者作為研究對象,其中實驗組(n=68)接受小切口纖維膽管鏡下取石法治療,對照組(n=56)接受腹腔鏡聯閤纖維膽管鏡取石法治療。結果：手術時間、手術齣血量、術後鎮痛率及腸道排氣時間組間比較差異無統計學意義(P>0.05),兩組組中轉開腹率(2.9% vs 16.0%)、結石殘留率(1.5% vs 14.3%)比較差異具有統計學意義(x2=6.549,、7.493,P<0.05),實驗組高于對照組。此外兩組患者總併髮癥髮生率比較差異無統計學意義(P>0.05),但實驗組急性胰腺炎、膽管感染髮生率少于對照組(5.9%、4.4%vs16.1%、12.5%),膽漏髮生率高于對照組(20.6%vs5.4%),差異均有統計學意義(X2=4.776、4.169、7.681,P<0.05)。結論：兩種微創的手術方法具有其各自的優勢,在治療方案的選擇上應根據患者的實際情況選擇閤適的方法,降低手術對于患者的創傷,儘可能提高手術的治療效果。
목적：탐토소절구담관섬유경취석술여복강경연합섬유담관경취석술대재보담취석중적림상료효여안전성。방법：124례보외과수치적결석성담낭염환자작위연구대상,기중실험조(n=68)접수소절구섬유담관경하취석법치료,대조조(n=56)접수복강경연합섬유담관경취석법치료。결과：수술시간、수술출혈량、술후진통솔급장도배기시간조간비교차이무통계학의의(P>0.05),량조조중전개복솔(2.9% vs 16.0%)、결석잔류솔(1.5% vs 14.3%)비교차이구유통계학의의(x2=6.549,、7.493,P<0.05),실험조고우대조조。차외량조환자총병발증발생솔비교차이무통계학의의(P>0.05),단실험조급성이선염、담관감염발생솔소우대조조(5.9%、4.4%vs16.1%、12.5%),담루발생솔고우대조조(20.6%vs5.4%),차이균유통계학의의(X2=4.776、4.169、7.681,P<0.05)。결론：량충미창적수술방법구유기각자적우세,재치료방안적선택상응근거환자적실제정황선택합괄적방법,강저수술대우환자적창상,진가능제고수술적치료효과。
Objective:To compare the clinical efficacy and safety of small incision in the bile ducts fiber lithotomy and laparoscopy combined with fiber choledochoscope stone treatment on the paul gall stone surgery.Methods:124 patients with cholecystitis in our hospital general department were randomly divided into experimental and control groups. Experimental group of 68 patients accepted the small incision fiber bile duct endoscopic stone extraction method,and control group of 56 patients accepted laparoscopy combined with fiber choledochoscope method.Results:Two surgical techniques, operative time, operative bleeding, postoperative analgesia rate and intestinal exhaust time was no significant difference (P>0.05).Residual stone rate(2.9%vs 16.0%)and the rconversion to open rate(1.5%vs 14.3%)between the two groups, the differences were statistically significant(X2=6.549、7.493,P<0.05).But in the experimental group ,the acute pancreatitis, the incidence of bile duct infection were all more than the control group (5.9%, 4.4%vs 16.1%,12.5%), the incidence of bile leakage was higher than that of the control group (20.6%vs5.4%), the differences were statistically significant (X2=4.776,4.169,7.681,P<0.05).Conclusion:The two minimally invasive surgical methods have their respective advantages.Choosing the appropriate method should be based on the actual situation of the patient on treatment options, to reduce the trauma of surgery for patients and maximize the therapeutic effect of the surgery.
